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Fernandes JO, Machado BF, Cardoso-Filho C, Nativio J, Cabello C, Vale DB. Breast cancer survival after mammography dissemination in Brazil: a population-based analysis of 2,715 cases. BMC Womens Health 2023; 23:644. [PMID: 38049765 PMCID: PMC10696793 DOI: 10.1186/s12905-023-02803-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 11/24/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND This study aims to assess breast cancer survival rates after one decade of mammography in a large urban area of Brazil. METHODS It is a population-based retrospective cohort of women with breast cancer in Campinas, São Paulo, from 2010 to 2014. Age, vital status and stage were accessed through the cancer and mortality registry, and patients records. Statistics used Kaplan-Meier, log-rank and Cox's regression. RESULTS Out of the 2,715 cases, 665 deaths (24.5%) were confirmed until early 2020. The mean age at diagnosis was 58.6 years. Women 50-69 years were 48.0%, and stage I the most frequent (25.0%). The overall mean survival was 8.4 years (8.2-8.5). The 5-year survival (5yOS) for overall, 40-49, 50-59, 60-69, 70-79 years was respectively 80.5%, 87.7%, 83.7%, 83.8% and 75.5%. The 5yOS for stages 0, I, II, III and IV was 95.2%, 92.6%, 89.4%, 71.1% and 47.1%. There was no significant difference in survival in stage I or II (p = 0.058). Compared to women 50-59 years, death's risk was 2.3 times higher for women 70-79 years and 26% lower for women 40-49 years. Concerning stage I, the risk of death was 1.5, 4.1 and 8.6 times higher, and 34% lower, respectively, for stage II, III, IV and 0. CONCLUSIONS In Brazil, breast cancers are currently diagnosed in the early stages, although advanced cases persist. Survival rates may reflect improvements in screening, early detection and treatment. The results can reflect the current status of other regions or countries with similar health care conditions.
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Affiliation(s)
- Juliana O Fernandes
- Department of Obstetrics and Gynecology, University of Campinas, Women's Hospital, Unicamp. Rua Alexander Fleming, 101, 13083-881, Cidade Universitária, Campinas, SP, Brazil
| | - Beatriz F Machado
- Department of Obstetrics and Gynecology, University of Campinas, Women's Hospital, Unicamp. Rua Alexander Fleming, 101, 13083-881, Cidade Universitária, Campinas, SP, Brazil
| | - Cassio Cardoso-Filho
- Department of Obstetrics and Gynecology, University of Campinas, Women's Hospital, Unicamp. Rua Alexander Fleming, 101, 13083-881, Cidade Universitária, Campinas, SP, Brazil
| | - Juliana Nativio
- Surveillance Section, Municipal Health Department, Campinas City Hall, Paço Municipal, Avenida Anchieta, nº 200, 13.015-904, Campinas, SP, Brazil
| | - Cesar Cabello
- Department of Obstetrics and Gynecology, University of Campinas, Women's Hospital, Unicamp. Rua Alexander Fleming, 101, 13083-881, Cidade Universitária, Campinas, SP, Brazil
| | - Diama B Vale
- Department of Obstetrics and Gynecology, University of Campinas, Women's Hospital, Unicamp. Rua Alexander Fleming, 101, 13083-881, Cidade Universitária, Campinas, SP, Brazil.
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Marcelino AC, Gozzi B, Cardoso-Filho C, Machado H, Zeferino LC, Vale DB. Race disparities in mortality by breast cancer from 2000 to 2017 in São Paulo, Brazil: a population-based retrospective study. BMC Cancer 2021; 21:998. [PMID: 34488654 PMCID: PMC8422690 DOI: 10.1186/s12885-021-08735-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/18/2021] [Indexed: 12/30/2022] Open
Abstract
Background In Brazil, inequalities in access may interfere with cancer care. This study aimed to evaluate the influence of race on breast cancer mortality in the state of São Paulo, from 2000 to 2017, contextualizing with other causes of death. Methods A population-based retrospective study using mortality rates, age and race as variables. Information on deaths was collected from the Ministry of Health Information System. Only white and black categories were used. Mortality rates were age-adjusted by the standard method. For statistical analysis, linear regression was carried out. Results There were 60,940 deaths registered as breast cancer deaths, 46,365 in white and 10,588 in black women. The mortality rates for 100,000 women in 2017 were 16.46 in white and 9.57 in black women, a trend to reduction in white (p = 0.002), and to increase in black women (p = 0.010). This effect was more significant for white women (p < 0.001). The trend to reduction was consistent in all age groups in white women, and the trend to increase was observed only in the 40–49 years group in black women. For ‘all-cancer causes’, the trend was to a reduction in white (p = 0.031) and to increase in black women (p < 0.001). For ‘ill-defined causes’ and ‘external causes’, the trend was to reduce both races (p < 0.001). Conclusion The declared race influenced mortality rates due to breast cancer in São Paulo. The divergences observed between white and black women also were evident in all cancer causes of death, which may indicate inequities in access to highly complex health care in our setting.
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Affiliation(s)
- Ana Cláudia Marcelino
- Obstetrics and Gynecology Department, State University of Campinas, Rua Alexander Fleming 101, Campinas, SP, CEP 13083-881, Brazil
| | - Bruno Gozzi
- Obstetrics and Gynecology Department, State University of Campinas, Rua Alexander Fleming 101, Campinas, SP, CEP 13083-881, Brazil
| | - Cássio Cardoso-Filho
- Obstetrics and Gynecology Department, State University of Campinas, Rua Alexander Fleming 101, Campinas, SP, CEP 13083-881, Brazil
| | - Helymar Machado
- Obstetrics and Gynecology Department, State University of Campinas, Rua Alexander Fleming 101, Campinas, SP, CEP 13083-881, Brazil
| | - Luiz Carlos Zeferino
- Obstetrics and Gynecology Department, State University of Campinas, Rua Alexander Fleming 101, Campinas, SP, CEP 13083-881, Brazil
| | - Diama Bhadra Vale
- Obstetrics and Gynecology Department, State University of Campinas, Rua Alexander Fleming 101, Campinas, SP, CEP 13083-881, Brazil.
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Zhu M, Yu Y, Shao X, Zhu L, Wang L. Predictors of Response and Survival Outcomes of Triple Negative Breast Cancer Receiving Neoadjuvant Chemotherapy. Chemotherapy 2020; 65:101-109. [PMID: 32894832 DOI: 10.1159/000509638] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/17/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND In triple negative breast cancer (TNBC) patients receiving neoadjuvant chemotherapy (NACT), pre-treatment predictors for pathological complete response (pCR) have been reported; however, those for progressive disease (PD) remain unidentified. METHODS We investigated pre-treatment clinicopathological predictors associated with pCR and PD by retrospectively reviewing data for 165 patients treated between 2015 and 2018. Patients with pCR and PD were compared to those without pCR and PD, respectively, using logistic regression and Kaplan-Meier methods. RESULTS Lack of androgen receptor (AR) was an independent predictor of pCR, while high histological grade, low Ki-67 index, and incomplete NACT courses were independent predictors of PD. Mean disease-free survival and overall survival were significantly poorer in PD patients than in pCR patients (15.7, 21.3 vs. 52.4, 56.3 months). CONCLUSIONS Insights into the chemo-resistance mechanisms and exploration of novel targeted agents in subgroups as per AR and Ki-67 status are needed to improve survival outcomes in TNBC patients.
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Affiliation(s)
- Meizhen Zhu
- School of Medicine, Zhejiang University, Hangzhou, China.,Department of Breast Surgery, Zhejiang Cancer Hospital, Cancer Hospital of the University of Chinese Academy of Sciences, Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, China
| | - Yang Yu
- Department of Breast Surgery, Zhejiang Cancer Hospital, Cancer Hospital of the University of Chinese Academy of Sciences, Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, China
| | - Xiying Shao
- Department of Breast Medical Oncology, Zhejiang Cancer Hospital, Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Cancer Hospital of the University of Chinese Academy of Sciences, Hangzhou, China
| | - Liang Zhu
- Department of Pathology, Zhejiang Cancer Hospital, Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Cancer Hospital of the University of Chinese Academy of Sciences, Hangzhou, China
| | - Linbo Wang
- Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China,
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Zhou J, Lei J, Wang J, Lian CL, Hua L, Yang LC, Wu SG. Validation of the 8 th edition of the American Joint Committee on Cancer Pathological Prognostic Staging for young breast cancer patients. Aging (Albany NY) 2020; 12:7549-7560. [PMID: 32320950 PMCID: PMC7202534 DOI: 10.18632/aging.103111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 03/31/2020] [Indexed: 11/25/2022]
Abstract
Purpose: This study aimed to validate the newly proposed American Joint Committee on Cancer (AJCC) pathological prognostic staging system for young breast cancer patients (aged ≤40 years). Results: We included 12811 women in this study. Overall, 52.8% of patients in the 7th AJCC stages were restaged to the 8th AJCC pathological staging system, including 10.7% upstaged and 42.1% downstaged. The receiver operating characteristics analysis showed that the new staging system had a better role in predicting breast cancer-specific survival (BCSS) compared with 7th edition staging (P<0.001). The results of the multivariate prognostic analysis showed that the hazard ratio of BCSS increased with the 8th AJCC stages, while the 7th anatomic stages had no significant difference in BCSS. Conclusions: The novel pathological staging system could provide more accurate prognostic stratification for young women with breast cancer because of the high proportion of stage migration. Patients and Methods: Data for young breast cancer patients diagnosed between 2010 and 2014 were included from the Surveillance, Epidemiology, and End Results program. Chi-squared test, Kaplan–Meier method, receiver operating characteristics curve, and Cox proportional hazard analysis were applied to statistical analysis.
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Affiliation(s)
- Juan Zhou
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, People's Republic of China
| | - Jian Lei
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, People's Republic of China
| | - Jun Wang
- Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, People's Republic of China
| | - Chen-Lu Lian
- Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, People's Republic of China
| | - Li Hua
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, People's Republic of China
| | - Li-Chao Yang
- Xiamen Key Laboratory of Chiral Drugs, Medical College, Xiamen University, Xiamen 361005, People's Republic of China
| | - San-Gang Wu
- Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, People's Republic of China
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Ayala ALM, Anjos JCD, Cassol GA, Höfelmann DA. [Survival rate of 10 years among women with breast cancer: a historic cohort from 2000-2014]. CIENCIA & SAUDE COLETIVA 2019; 24:1537-1550. [PMID: 31066855 DOI: 10.1590/1413-81232018244.16722017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 07/25/2017] [Indexed: 11/21/2022] Open
Abstract
Breast cancer is a public health problem due to its high incidence, morbidity and mortality. The analysis of survival for this disease contributes to the description of behavior and prognostic factors. The scope of this article is to investigate survival for 10 years after diagnosis and the prognostic factors of women with breast cancer admitted to the Unified Health System Mastology Service in Joinville, State of Santa Catarina, between 2000 and 2014. A historical cohort study with data from the medical records and death certificates of 1,321 women, of whom 471 were considered eligible under the minimum follow-up criteria of 10 years (n = 288), and/or death before this period (n = 183). Survival analysis using the Kaplan-Meier model, the Log-Rank test and the Cox regression model was conducted. Overall survival at 10 years was 41% (CI 95%, 36.1%-45.0%). The risk of 10-year mortality stratified by tumor staging was higher among women with lymphatic invasion and staging II, and staging III, at 60 years or older. The findings suggest that the presence of lymphatic invasion, advanced age and intermediate/advanced staging of the disease can be considered indicators of a worse prognosis for breast cancer.
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Gene aberration profile of tumors of adolescent and young adult females. Oncotarget 2017; 9:6228-6237. [PMID: 29464067 PMCID: PMC5814207 DOI: 10.18632/oncotarget.23765] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 09/21/2017] [Indexed: 12/31/2022] Open
Abstract
There has been little improvement in the prognosis for adolescent and young adult (AYA) tumor patients. Hence, there is an urgent need to understand the etiology of tumor development and identify actionable gene aberrations to improve prevention and therapy. Here, 76 sporadic tumors (48 breast, 22 ovarian, and six uterine) from 76 AYA females (age range, 25–39 years) were subjected to whole exome and RNA sequencing to determine their mutational signatures and actionable gene profiles. Two individuals with breast cancer (4.2% of cases) and one with ovarian cancer (5.3% of cases) carried germline BRCA2 mutations. The two cases with breast tumors also each carried an additional deleterious germline mutation: one in TP53 and the other in CHEK2. Mutational signature analysis of the 76 tumors indicated that spontaneous deamination of 5-methylcytosine and activity of the APOBEC cytidine deaminase protein family are major causes of mutagenesis. In addition, 18 breast or ovarian tumors (18/70, 26%), including the three cases with germline BRCA2 mutations, exhibited a predominant “BRCAness” mutational signature, an indicator of functional BRCA1/BRCA2 deficiency. Actionable aberrations and high tumor mutation burdens were detected in 24 breast (50%), 17 ovarian (77%), and five uterine (83%) tumor cases. Thus, mutational processes and aberrant genes in AYA tumors are largely shared with those identified in non-AYA tumors. The efficacy of molecular targeting and immune checkpoint inhibitory therapies should be explored for both AYA and non-AYA patients.
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Acevedo F, Camus M, Sanchez C. Breast cancer at extreme ages--a comparative analysis in Chile. Asian Pac J Cancer Prev 2015; 16:1455-61. [PMID: 25743815 DOI: 10.7314/apjcp.2015.16.4.1455] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Young onset breast cancer (BC) has a worse outcome as compared to in the elderly. However, some studies have shown that BC in the elderly, despite indolent features, does also cause increase in mortality. In an attempt to compare clinic-pathological characteristics, BC subtypes and survival in patients with BC presenting at extremes of age, we performed a retrospective study. MATERIALS AND METHODS Patients were either ≤40 or ≥70 years old. Subtypes were defined using immunohistochemistry and histological grade. Chi-Square test was used for evaluation of categorical variables, and Kaplan-meier and log-rank for disease-specific survival (DSS) and disease free survival (DFS) . RESULTS We analyzed 256 patients ≤40 and 366 patients ≥70. Younger patients presented with more aggressive disease, with less luminal A but more luminal B and triple negative (TN) subtype. With a median follow-up of 57.5 months, DFS at 5 years in younger patients was 72.3% vs 84.6% in the elderly (p=0.007). Luminal A and B disease presented with worse DFS in younger patients. The opposite was seen in the TN subgroup. Although we found no significant differences in DSS, older patients with TN tumors died of BC more frequently. This group also received less chemotherapy. CONCLUSIONS Young patients present with more aggressive disease, this translating into worse DFS. However, elderly patients with TN disease represent a particular subpopulation with worse DFS and DSS, suggesting that chemotherapy should not be withheld only because of age.
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Affiliation(s)
- Francisco Acevedo
- Department of Hematology-Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile E-mail :
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Yeo W, Lee HM, Chan A, Chan EYY, Chan MCM, Chan KW, Chan SWW, Cheung FY, Cheung PSY, Choi PHK, Chor JSY, Foo WWL, Kwan WH, Law SCK, Li LPK, Tsang JWH, Tung Y, Wong LLS, Wong TT, Yau CC, Yau TK, Zee BCY. Risk factors and natural history of breast cancer in younger Chinese women. World J Clin Oncol 2014; 5:1097-1106. [PMID: 25493246 PMCID: PMC4259937 DOI: 10.5306/wjco.v5.i5.1097] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 06/20/2014] [Accepted: 07/29/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the age differences in the risk factors, clinicopathological characteristics and patterns of treatment of female breast cancer patients.
METHODS: Seven thousand one hundred and fifty-two women with primary breast cancer from the Hong Kong Breast Cancer Registry were recruited after receiving patients’ consent, they were asked to complete standardized questionnaires which captured their sociodemographic characteristics and risk factors associated with breast cancer development. Among them, clinicopathological data and patterns of treatment were further collected from medical records of 5523 patients with invasive breast cancers. Patients were divided into two groups according to the age at diagnosis: younger (< 40 years old) vs older patients (≥ 40 years old) for subsequent analyses.
RESULTS: Analysis on the sociodemographic characteristics and exposure to risk factors were performed on 7152 women with primary breast cancer and the results revealed that younger patients were more likely to have unhealthy lifestyles; these include a lack of exercise (85.4% vs 73.2%, P < 0.001), having high stress in life (46.1% vs 35.5%, P < 0.001), having dairy/meat-rich diets (20.2% vs 12.9%, P < 0.001), having alcohol drinking habit (7.7% vs 5.2%, P = 0.002). Younger patients were also more likely to have hormone-related risk factors including nulliparity (43.3% vs 17.8%, P < 0.001) and an early age at menarche (20.7% vs 13.2%, P < 0.001). Analyses on clinicopathological characteristics and patterns of treatment were performed on 5523 women diagnosed with invasive breast cancer. The invasive tumours in younger patients showed more aggressive pathological features such as having a higher percentage of grade 3 histology (45.7% vs 36.5%, P < 0.001), having a higher proportion of tumours with lymphovascular invasion (39.6% vs 33.2%, P = 0.003), and having multifocal disease (15.7% vs 10.3%, P < 0.001); they received different patterns of treatment than their older counterparts.
CONCLUSION: Younger patients in Hong Kong are more likely to encounter risk factors associated with breast cancer development and have more aggressive tumours than their older counterparts.
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Dialla PO, Quipourt V, Gentil J, Marilier S, Poillot ML, Roignot P, Altwegg T, Darut-Jouve A, Guiu S, Arveux P, Dabakuyo-Yonli TS. In breast cancer, are treatments and survival the same whatever a patient's age? A population-based study over the period 1998-2009. Geriatr Gerontol Int 2014; 15:617-26. [DOI: 10.1111/ggi.12327] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Pegdwende Olivia Dialla
- Breast and Gynaecologic Cancer Registry of Côte d'Or; Centre Georges François Leclerc Comprehensive Cancer Centre; Dijon Cedex France
- EA 4184; Faculty of Medicine; University of Burgundy; Dijon France
| | - Valérie Quipourt
- Coordination Unit in Geriatric Oncology in Burgundy; Hôpital de jour Gériatrique; Hôpital de Champmaillot; Dijon Cedex France
| | - Julie Gentil
- Breast and Gynaecologic Cancer Registry of Côte d'Or; Centre Georges François Leclerc Comprehensive Cancer Centre; Dijon Cedex France
- EA 4184; Faculty of Medicine; University of Burgundy; Dijon France
| | - Sophie Marilier
- Coordination Unit in Geriatric Oncology in Burgundy; Hôpital de jour Gériatrique; Hôpital de Champmaillot; Dijon Cedex France
| | - Marie-Laure Poillot
- Breast and Gynaecologic Cancer Registry of Côte d'Or; Centre Georges François Leclerc Comprehensive Cancer Centre; Dijon Cedex France
- EA 4184; Faculty of Medicine; University of Burgundy; Dijon France
| | | | | | | | - Sévérine Guiu
- Department of Medical Oncology; Centre Georges François Leclerc Comprehensive Cancer Centre; Dijon Cedex France
| | - Patrick Arveux
- Breast and Gynaecologic Cancer Registry of Côte d'Or; Centre Georges François Leclerc Comprehensive Cancer Centre; Dijon Cedex France
- EA 4184; Faculty of Medicine; University of Burgundy; Dijon France
| | - Tienhan Sandrine Dabakuyo-Yonli
- EA 4184; Faculty of Medicine; University of Burgundy; Dijon France
- Biostatistics and Quality of Life Unit; Centre Georges François Leclerc Comprehensive Cancer Centre; Dijon Cedex France
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Alieldin NH, Abo-Elazm OM, Bilal D, Salem SE, Gouda E, Elmongy M, Ibrahim AS. Age at diagnosis in women with non-metastatic breast cancer: Is it related to prognosis? J Egypt Natl Canc Inst 2013; 26:23-30. [PMID: 24565679 DOI: 10.1016/j.jnci.2013.08.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 08/25/2013] [Accepted: 08/28/2013] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Primary objective was to verify whether breast cancer patients aged less than 40 years at diagnosis have poorer prognosis than older patients. Secondary to assess prognostic factors influencing disease free survival. METHODS 941 women were diagnosed with non-metastatic breast cancer at NCI, Cairo in 2003. Epidemiologic, clinico-pathological characteristics, treatment modalities and disease free survival were compared among the two age groups. Prognostic factors were evaluated for association with disease-free survival. RESULTS One hundred-eighty-one patients (19.2%) were younger than 40 years and 760 (80.8%) were older. Older women presented with higher rates of comorbidities and younger women presented with more hormone non-responsive tumors. Young women presented with larger tumors pT4=13.8% compared to 8.6% in older women, yet not significant. Young women were treated with more conservative surgery, more adjuvant chemotherapy and radiotherapy while older women with more radical mastectomies and more hormonal treatment. Recurrence rates were significantly higher among young women 44.2% compared to 34.5% in older women. Five year disease free survival in young women was 38.9% ± 4.6% compared to 48.6% ± 2.5% with adjusted hazard ratio of 1.22 95% CI (0.91-1.64), p=0.19. Multivariate analyses identified positive axillary lymph nodes (pN2-pN3), larger tumor size (pT3-pT4), hypertension, lobular carcinoma type and lack of adjuvant systemic treatment as independent factors associated with poor DFS. CONCLUSION Young women were not found to have poorer prognosis, yet they presented with more ER negative tumors. Most of women presented with advanced stage and young women had higher recurrence rates.
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Affiliation(s)
- Nelly H Alieldin
- Department of Biostatistics and Cancer Epidemiology, National Cancer Institute NCI, Cairo University, Fom Elkhalig Sq, Cairo, Egypt.
| | - Omnia M Abo-Elazm
- Department of Biostatistics and Cancer Epidemiology, National Cancer Institute NCI, Cairo University, Fom Elkhalig Sq, Cairo, Egypt
| | - Dalia Bilal
- Department of Biostatistics and Cancer Epidemiology, National Cancer Institute NCI, Cairo University, Fom Elkhalig Sq, Cairo, Egypt
| | - Salem Eid Salem
- Department of Medical Oncology, NCI, Cairo University, Fom Elkhalig Sq, Cairo, Egypt
| | - Eman Gouda
- Department of Pathology, NCI, Cairo University, Fom Elkhalig Sq, Cairo, Egypt
| | - Magda Elmongy
- Department of radiotherapy, NCI, Cairo University, Fom Elkhalig Sq, Cairo, Egypt
| | - Amal S Ibrahim
- Department of Biostatistics and Cancer Epidemiology, National Cancer Institute NCI, Cairo University, Fom Elkhalig Sq, Cairo, Egypt
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Comparison of clinicopathologic features and survival in young American women aged 18-39 years in different ethnic groups with breast cancer. Br J Cancer 2013; 109:1302-9. [PMID: 23907433 PMCID: PMC3778276 DOI: 10.1038/bjc.2013.387] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 06/18/2013] [Accepted: 06/24/2013] [Indexed: 12/03/2022] Open
Abstract
Background: Ethnic disparities in breast cancer diagnoses and disease-specific survival (DSS) rates in the United States are well known. However, few studies have assessed differences specifically between Asians American(s) and other ethnic groups, particularly among Asian American(s) subgroups, in women aged 18–39 years. Methods: The Surveillance, Epidemiology, and End Results database was used to identify women aged 18–39 years diagnosed with breast cancer from 1973 to 2009. Incidence rates, clinicopathologic features, and survival among broad ethnic groups and among Asian subgroups. Results: A total of 55 153 breast cancer women aged 18–39 years were identified: 63.6% non-Hispanic white (NHW), 14.9% black, 12.8% Hispanic-white (HW), and 8.7% Asian. The overall incidence rates were stable from 1992 to 2009. Asian patients had the least advanced disease at presentation and the lowest risk of death compared with the other groups. All the Asian subgroups except the Hawaiian/Pacific Islander subgroup had better DSS than NHW, black, and HW patients. Advanced tumour stage was associated with poorer DSS in all the ethnic groups. High tumour grade was associated with poorer DSS in the NHW, black, HW, and Chinese groups. Younger age at diagnosis was associated with poorer DSS in the NHW and black groups. Conclusion: The presenting clinical and pathologic features of breast cancer differ by ethnicity in the United States, and these differences impact survival in women younger than 40 years.
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Nagatsuma AK, Shimizu C, Takahashi F, Tsuda H, Saji S, Hojo T, Sugano K, Takeuchi M, Fujii H, Fujiwara Y. Impact of recent parity on histopathological tumor features and breast cancer outcome in premenopausal Japanese women. Breast Cancer Res Treat 2013; 138:941-50. [PMID: 23553566 DOI: 10.1007/s10549-013-2507-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 03/25/2013] [Indexed: 02/03/2023]
Abstract
Although previous studies have reported that onset at young age is associated with poor prognosis in breast cancer, the correlation between reproductive factors, breast cancer characteristics, and prognosis remains unclear. Five hundred and twenty-six premenopausal young women diagnosed with primary invasive breast cancer between January 2000 and December 2007 were included in this study. Patients were classified into four groups according to their reproductive history: women who gave birth within the previous 2 years (group A), women who gave birth between 3 and 5 years previously (group B), women who gave birth more than 5 years previously (group C), and nulliparous women (group N). The correlation between the time since last childbirth to diagnosis, histopathological tumor features, and breast cancer prognosis was evaluated. Breast cancer patients who had given birth more recently had more advanced stage tumors; larger sized tumors; a higher rate of axillary lymph node metastases; a higher histological tumor grade; and increased progesterone receptor (PgR)-, HER2+, and triple negative tumors than patients who had given birth less recently or not at all. Group A patients had significantly shorter survival times than patients in both groups C and N (log rank test; p < 0.001). After adjusting for tumor characteristics, the hazard ratio for death in group A was 2.19 compared with group N (p = 0.036), and the adjusted hazard ratio restricted to patients in group A with hormone-receptor-positive, and HER2- tumors was 3.07 (p = 0.011). Young breast cancer patients who had given birth more recently had tumors with more aggressive features and worse prognoses compared with patients who had given birth less recently or were nulliparous.
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Affiliation(s)
- Akiko Kawano Nagatsuma
- Division of Breast and Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
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Age at diagnosis and breast cancer survival in iran. Int J Breast Cancer 2012; 2012:517976. [PMID: 23227345 PMCID: PMC3512268 DOI: 10.1155/2012/517976] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 09/26/2012] [Accepted: 10/14/2012] [Indexed: 01/23/2023] Open
Abstract
Background. Tumour characteristics are the most important prognostic factors in breast cancer. Patient-related factors such as young age at diagnosis, obesity, and smoking behaviour may also modify disease outcome. Due to the absence of a unique definition for "young age breast cancer" and the resulting variation in disease management, findings on the association between young age and prognosis of breast cancer are controversial. Methods. This study included 1500 patients with a primary diagnosis of breast cancer in six Iranian hospitals from 5 provinces. We modelled the relative excess risk (RER) of breast cancer death to age at diagnosis and tumour characteristics. Results. Excess risks of death were observed for stage IV disease and poorly differentiated tumours: RER of 4.3 (95% CI: 1.05-17.65) and 3.4 (95% CI: 1.17-9.87), respectively. "Older" patients, particularly those aged 50 and over, presented more often with advanced and poorly differentiated tumours (P = 0.001). After adjustment for stage, histological grade, Her-2 expression, estrogen and progesterone receptors, and place of residency, breast cancer mortality was not significantly different across age groups. Conclusion. We conclude that there is no prognostic effect of age at diagnosis of breast cancer among breast cancer patients treated at cancer centres in different parts of Iran; young and relatively old women have similar risks of dying from breast cancer.
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Yang H, Yu X, He X, Fan J, Li J, Xu F, Zhang B, Tang Z, Zheng S, Qiao Y. Age Interactions in Breast Cancer: An Analysis of a 10-Year Multicentre Study in China. J Int Med Res 2012; 40:1130-40. [PMID: 22906287 DOI: 10.1177/147323001204000333] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES: The effects of age at diagnosis on the clinical characteristics of breast cancer and trends over time were investigated in Chinese women. METHODS: Data from 4211 women with pathologically confirmed primary breast cancer collected between 1999 and 2008 for a multicentre retrospective study were analysed according to age at diagnosis. RESULTS: Age at diagnosis ranged from 21 to 86 years, with a mean of 48.7 years, and was shown to be significantly related to tumour size, lymph node status, hormone receptor status and human growth factor receptor-2 status, but not to pathological type or tumour, node, metastasis stage. The age-corrected proportion of patients aged 50 – 64 years at diagnosis increased significantly between 1999 and 2008. There was a significant difference in the age-corrected distribution of age at diagnosis in China compared with Western countries. CONCLUSIONS: Age at diagnosis is related to the clinical and pathological characteristics of breast cancer. The age at diagnosis in China increased over the decade from 1999 to 2008, but is still lower than in Western countries.
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Affiliation(s)
- Hj Yang
- Department of Breast Surgery, Zhejiang Cancer Hospital, Banshanqiao, Hangzhou, China
| | - Xf Yu
- Department of Breast Surgery, Zhejiang Cancer Hospital, Banshanqiao, Hangzhou, China
| | - Xm He
- Department of Breast Surgery, Zhejiang Cancer Hospital, Banshanqiao, Hangzhou, China
| | - Jh Fan
- Department of Cancer Epidemiology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - J Li
- Department of Cancer Epidemiology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - F Xu
- Department of Breast—Thyroid Surgery, Xiangya Second Hospital, Central South University, Changsha, China
| | - Bn Zhang
- Centre of Breast Disease, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zh Tang
- Department of Breast—Thyroid Surgery, Xiangya Second Hospital, Central South University, Changsha, China
| | - S Zheng
- Department of Pathology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yl Qiao
- Department of Cancer Epidemiology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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